Super 30 Entry Form (Go to LMCD Form)

  • Captain's Name   Membership in Denny’s Super 30 is open to all men and women. Anyone under the age of 16 years must fish with a parent or legal guardian. Both anglers of a team must be members. Acceptance of the prize constitutes permission for Denny's Super 30 and its sponsors to use winner's name and/or likeness, biographical material and/or entry (including an altered form of the entry) for advertising and promotional purposes without additional compensation.
    Social Security #  
    Street Address  
    City  
    State Zip Code  
    Work Phone  
    Home Phone  
    E-mail  
    Signature  
  • Partner's Name
    Social Security #
    Street Address
    City
    State Zip Code
    Work Phone
    Home Phone
    E-mail
    Signature
  • Check the tournaments you are entering.
    Membership Fee (per team)

    $40.00
    Minnetonka  5/26/09 AIA

    $350.00
    Minnetonka 6/15/09

    $300.00
    Minnetonka 7/13/09

    $300.00
    Minnetonka 8/17/09

    $300.00
    Minnetonka 9/14/09

    $300.00
     

    TOTAL

    Mail check & Signed entry form to:
    DENNY’S SUPER 30
    8014 Pennsylvania Road
    Bloomington, MN 55438
    Cell 612-201-2406